Background: In the absence of contraindications, current guidelines recommend ≥ 150 minutes/week of moderate-intensity aerobic activity for women during pregnancy for the prevention of excess weight gain, metabolic abnormalities (e.g., gestational diabetes), and the general health of both mother and offspring. In the U.S., approximately 20% of pregnant women meet this recommendation. The perceived quality of the built environment may play an important role in supporting or hindering active living during pregnancy. Thus, this study examined the association of environmental supports for physical activity (PA) with PA behaviors in a population of pregnant women.
Methods: The study included 155 pregnant women in the Ohio State University Wexner Medical Center that self-reported PA behaviors during the third trimester (27+ weeks). Participants also rated 26 perceived environmental supports and barriers for PA in four domains: outdoor recreation supports, access to a safe walking environment, neighborhood and community supports, and public recreation facilities; the total environmental quality score ranged from 0 (worst) to 26 (best). Logistic regression was used to examine the association of the total and subscale scores with achievement of ≥150 minutes of moderate-to-vigorous physical activity (MVPA) during the pregnancy, maintenance of pre-pregnancy PA level, and change in moderate PA from the 1st through 3rd trimester.
Results: The study included women between the ages of 20-46 years that were between 27-40 weeks pregnant. The mean age was 32 years (SD=4.3 years). Fifty percent of the study population reported achieving ≥150 minutes per week of MVPA. Women with access to a safe walking environment were more likely to maintain or increase their PA during pregnancy [adjusted OR (aOR) per 1-point increase in PA score = 1.61, 95% CI: 1.14-2.28, p<0.01]; a safe walking environment was characterized by perceptions of physically active neighbors, lack of concern about unattended pets, safe and well-maintained sidewalks, and adequate street lighting. Participants that reported better access to public recreational facilities were also more likely to maintain or increase moderate PA levels throughout their pregnancy (aOR = 1.24, 95% CI: 1.05 - 1.47, p<0.05).
Conclusions: Perceived access to a safe environment and neighborhood public recreation facilities are strongly associated with achievement and maintenance of recommended PA throughout pregnancy. Interventions at the individual-level have been shown to promote PA during pregnancy. Combining these efforts with community-level interventions that enhance the built environment to include access to safe outdoor space for leisure and recreational facilities may also positively impact the metabolic health of expectant mothers.